health_care_policyfandomcom-20200214-history
Important aspects of public healthcare part 2
Children's Health Insurance Program (CHIP). In 1997 Children’s Health Insurance Program (CHIP) was created. It is a program funded by individual states as well as federally. This program was developed for children in families that are in poverty but not eligible for Medicaid (Bodenheimer & Grumbach, 2016). States can tailor the CHIP program but under federal regulations since they receive funds from the federal government (Bodenheimer & Grumbach, 2016). It can be an extension of Medicaid, a separate program or a combination. As a Medicaid expansion. The state must offer Medicaid services to all low-income children under the age of 21. Services include prevention, diagnostic and treatment services. By granting access to this population, health issues can be averted or diagnosed and treatment given sooner (Centers for Medicare& Medicaid Services, n.d). When states opt for CHIPS as a separate program, the state offers benchmark coverage. In addition to standard coverage, services such as inpatient or outpatient hospital service; physicians medical and surgical service; and lab or x-ray services. These additional services are offered via three different benefit plans. The first is federal employee health benefit plan: standard Blue Cross Blue Shield (BCBS) plan offered to federal employees. The second is a state employee plan which typically is the same plan offered to state employees. Lastly, health maintenance organization plan entails coverage offered through HMO; large and commercial insurer. (Centers for Medicare &Medicaid Services, n.d) Regardless of which CHIP is offered, all states must provide well-baby and well-child visits, dental coverage, behavioral health coverage, and vaccines. (Centers for Medicare & Medicaid Services, n.d). To be eligible for this program, it will vary by state. According to Centers for Medicare and Medicaid Services (n.d), 46 states and the District of Columbia cover children up to or above 200% of the Federal Poverty Level (FPL), and 24 of these states offers coverage to children in families with income at 250% of the FPL or higher. States may get the CHIP enhanced match for coverage up to 300% of the FLPL, which is higher than the Medicaid federal funding matching rate. States that expand coverage above 300% of the FPL get the Medicaid matching rate. States have the option to provide continuous eligibility who remain eligible for CHIP. Veterans Health Administration (VHA). Veterans Health Administration is a federally funded service for those who served in the military. To be eligible for Veterans affairs (VA) healthcare you must have served in active military, naval or air service and must have not received a dishonorable discharge (United States Department of Veterans Affairs, n.d). Current minimum requirements do not apply if you were discharged due to disability caused by your active duty, discharged for hardship or served prior to September 7, 1980 (United States Department of Veteran Affairs, n.d). No veteran receives the same benefits since no tour in the military is the same. There are priority groups that received more benefits than other and those include: service connected disability, recent combat veteran, VA pension recipient, former prisoner of war, Purple heart recipient, medal of honor recipient, qualify for Medicaid, and specific service locations and dates (United States Department of Veterans Affairs, n.d). If none of the above apply to a veteran, they may still be eligible based on income dependent on their location and additional paperwork must be filled out. VA benefits are not affected by additional coverages such as private insurance, Medicare or Medicaid. If a veteran is permanently disabled or killed, the spouse and children may qualify for Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) which covers some costs associated with health care services. Indian Health Services (IHS). Indian Health Service is another federally funded program and located within the Department of Health and Human Services. This service is was established in the Constitution and reformed many times in laws, treaties, Executive orders and Supreme Court Decisions. Health Services are offer to American Indians and Alaska Natives. The government recognized 573 tribes, or 2.6 million people can receive this service. The IHS budget is ever evolving (Indian health Service, n.d). Tribes and key stakeholders meet with the government to ensure their communities are adequately covered, the budget proposal is the taken for review to the Appropriations committee in the House and Senate. It is up to the individual to maintain a relationship with the IHS facility to retain benefits. These benefits encourage health promotion and disease prevention but cover a wide array of services (Indian Health Manual, n.d). Affordable Care Act. It seems necessary at this point to discuss the Affordable Care Act. This reform was passed in 2010 and has three primary goals: make health insurance more affordable to more people, expand the Medicaid program and support innovative medical care delivery methods to lower costs of health care generally (Affordable Care Act, 2010). The federal poverty level is determined every year by the Department of Health and Human Services (HHS) and can determine eligibility for federal programs like Medicaid, CHIP and a savings on Marketplace Health insurance. The Medicaid program expansion has varied by state and some included the redefined income status to include more people with low income. Other states have not changed their limits. With either decision regarding the expansion, there is a direct affect on how many people are enrolled in CHIP. CHIP is also determined by income and poverty level. Redefining the poverty level has allowed for additional children and adults to have coverage for preventive health and maintenance of current disease states. References Affordable Care Act (2010). Retrieved from www.healthcare.gov/glossary/affordable -care-act/ Bodenheimer, T.S.& Grumbach, K. (2016). Understanding health policy: a clinical approach (7th ed.). New York: McGraw Hill Centers for Medicare and Medicaid (n.d). Retrieved from www.medicaid.gov/chip/index.html. Indian Health Manual (n.d). Retrieved from www.ihs.gov United States Department of Veterans Affairs (n.d). Retrieved from www.va.gov